Tzialla Chryssoula, Arossa Alessia, Mannarino Savina, Orcesi Simona, Veggiotti Pierangelo, Fiandrino Giacomo, Zuffardi Orsetta, Errichiello Edoardo
Neonatal Intensive Care Unit, IRCCS Foundation Policlinico San Matteo, Pavia, Italy.
Unit of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo, Pavia, Italy.
Eur J Med Genet. 2022 Dec;65(12):104639. doi: 10.1016/j.ejmg.2022.104639. Epub 2022 Oct 4.
Variants in SCN2A, encoding the voltage-gated sodium channel Nav1.2, are commonly associated with developmental and epileptic encephalopathy. Although animal studies demonstrated a role for Nav1.2 in intraventricular conduction, heart anomalies have been only occasionally described in patients with SCN2A variants. In this report we trace the prenatal and neonatal history of a fetus/newborn with a de novo pathogenic variant in the SCN2A gene identified by prenatal trio whole-exome sequencing (WES). In addition to more typically SCN2A-associated neurological manifestations, the patient showed sustained tachyarrhythmia, potentially expanding the phenotypic spectrum associated with SCN2A variants and raising the question of whether cardiological assessment and prompt pharmacological intervention in SCN2A channelopathies to avoid heart complications might be beneficial. To the best of our knowledge, this represents the first clinical description of a SCN2A phenotype in a prenatal setting, as well as the first SCN2A diagnosis achieved by prenatal trio-WES approach.
编码电压门控钠通道Nav1.2的SCN2A基因变异通常与发育性和癫痫性脑病相关。尽管动物研究表明Nav1.2在室内传导中起作用,但SCN2A基因变异患者中仅偶尔有心脏异常的描述。在本报告中,我们追踪了一名胎儿/新生儿的产前和新生儿病史,该胎儿/新生儿通过产前三联全外显子测序(WES)鉴定出SCN2A基因的新生致病性变异。除了更典型的与SCN2A相关的神经学表现外,该患者还出现持续性快速心律失常,这可能会扩大与SCN2A基因变异相关的表型谱,并引发一个问题,即对SCN2A通道病进行心脏评估和及时的药物干预以避免心脏并发症是否有益。据我们所知,这是产前环境中SCN2A表型的首次临床描述,也是通过产前三联WES方法实现的首次SCN2A诊断。